Impact of penicillin susceptibility on medical outcomes for adult patientswith bacteremic pneumococcal pneumonia

The impact of penicillin susceptibility on medical outcomes for adult patie nts with bacteremic pneumococcal pneumonia was evaluated in a retrospective cohort study conducted during population-based surveillance for invasive p neumococcal disease in the greater Atlanta region during 1994. Of the 192 s tudy patients, 44 (23%) were infected with pneumococcal strains that demons trated some degree of penicillin nonsusceptibility. Compared with patients infected with penicillin-susceptible pneumococcal strains, patients whose i solates were nonsusceptible had a significantly greater risk of in-hospital death due to pneumonia (relative risk [RR], 2.1; 95% confidence interval [ CI] 1-4.3) and suppurative complications of infection (RR, 4.5; 95% CI, 1-1 9.3), although only risk of suppurative complications remained statisticall y significant after adjustment for baseline differences in severity of illn ess, Among adults with bacteremic pneumococcal pneumonia, infection with pe nicillin-nonsusceptible pneumococci is associated with an increased risk of adverse outcome.